Form

Get medical proof of domestic violence

Use this letter to get evidence of any illness, physical or mental harm caused by domestic violence, if you're applying for legal aid.

• From: Legal Aid Agency
• Published: 14 December 2014
• Last updated: 25 April 2016 — See all updates

Applies to England and Wales

Documents

Health professional response to request for evidence of injuries/condition consistent with domestic violence

MS Word Document, 13.8 KB

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

To ask for confirmation from the medical staff who treated you:

• fill in the sample letter as best you can
• send it to the doctor, dentist, midwife, nurse practitioner, psychologist, paramedic, radiographer or social worker who saw you

If you can’t remember who treated you, contact your GP or the hospital you visited. Another health professional will be able to help.

You may have to pay a fee.

You can use the medical letter as evidence when you apply for legal aid to divorce or separate from an abusive partner.

If you’re a doctor, dentist, midwife, nurse, practitioner psychologist, paramedic, radiographer or social worker, you can adapt this letter to give evidence of diagnosing injuries or conditions consistent with domestic abuse.

You can also sign this letter if you’re a health professional and have access to relevant medical records but did not make the diagnosis yourself.

You need to give evidence when victims of domestic violence apply for legal aid.

Published 14 December 2014
Last updated 25 April 2016 + show all updates

1. 25 April 2016

   Sample letter updated.

2. 14 December 2014

   First published.